Spotlight: ANTHEM BLUE CROSS / UCLA HEALTH SYSTEM CONTRACT NEGOTIATIONS

February 06, 2024

ANTHEM BLUE CROSS / UCLA HEALTH SYSTEM CONTRACT NEGOTIATIONS - UPDATED FEBRUARY 6, 2024

If your doctor(s) is NOT part of the UC Health system, this notice does not apply to you.

Anthem Blue Cross and UC Health have agreed in principle on a new contract providing Anthem members access to affordable care at UC Health’s doctors and hospitals for years to come. The organizations have also agreed to extend our current contract to April 1, 2024, allowing time to finalize the new contract and offer Anthem members uninterrupted in-network care at UC Health. This underscores our mutual commitment to providing Anthem’s consumers and employers with access to high quality, affordable care at UC Health.

Here is the latest update from Anthem:

https://www.anthem.com/ca/uchealth/

POSTED JANUARY 11, 2024:

As you may have heard, there are ongoing contract negations with Anthem and UC Health, which includes the UCLA Health system. While we hoped negotiations would have concluded by now, they have not, and as such, the carrier was required to notify HMO participants whose Primary Care Physician (“PCP”) is in-network with the UC Health System that a new Primary Care Physician will be assigned to them on March 1st, 2024 if the two parties do not come to an agreement, or agree to an extension, by February 29, 2024. Though Anthem’s notices have been limited to HMO participants with affected Primary Care Physicians, if the parties do not reach an agreement by February 29, UCLA Health will no longer be considered part of the Anthem Blue Cross network. This would apply to UCLA Health in-network PPO doctors as well, making them out-of-network.

PHBP is monitoring the situation. We of course are not involved in the ongoing negotiations and cannot advise you on a course of action one way or the other. If you are concerned your PCP may change on March 1 and you do not want to wait until the matter is resolved to find an alternate PCP or do not want to accept the PCP assigned by Anthem on March 1st - knowing you may ALWAYS change your PCP and are not required to stay with a carrier assigned PCP as long as your chosen replacement is in-network and accepts you as a new patient - you may want to start considering your options. While we are hopeful Anthem and UC Health will reach an agreement, as is usual in these circumstances, if you are not able to or are not comfortable with waiting to see how things unfold, you can find instructions on how to find an in-network doctor in the “Additional Resources” section of your 2024 Enrollment Guide for CA Freelancers here and for CA Staff employees here.

PHBP has seen contract negotiations between a carrier and a major provider come down to the wire before, and customarily each side realizes the value of their partnership and comes to an agreement. While we of course cannot make predictions - much less guarantees - on third party contract negotiations, we do know both sides continue to work in good faith to come to an agreement and avoid the termination of UC Health from the Anthem network.

Anthem states “There is no immediate impact to those currently receiving care or who have pre-authorized services through UC Health.” For additional information on issues of continuing care, please see Anthem’s published FAQ in the link below.

Anthem’s notice(s) and any news and updates contained therein or otherwise provided by Anthem will supersede this and any other notice provided by PHBP. All questions should be directed to Anthem by using the phone number listed on your Anthem ID Card.